Coronavirus Update 3/19/2020

These are uncertain and anxious times for all of us. The number of restrictions seem to grow by the hour, and news is coming at us from so many directions.  We are doing our best to respond promptly to your questions and make regular updates via email and social media so that you have the facts. Social distancing can feel isolating, so remember that going for walks, working in the yard, talking with neighbors (from about 6ft. away), and taking care of your other health needs is NOT canceled. We encourage you to keep your follow-up appointments that are already scheduled (more on that in a minute), maintain your medication regimen, and reach out to us if your anxiety or depression is especially worrying to you right now.

Let’s start with some updates (Please visit our website blog for previous info shared regarding COVID-19 —

As of this morning, there are 93 confirmed cases in NC, all of these are still considered active.  There have been no COVID-19 related fatalities in NC.  There is also now 1 confirmed case in New Hanover County. Brunswick and Onslow Counties also have 1 confirmed case each. The county public health teams are working closely with the individuals with the virus to make contact with anyone they have had close contact with over the last two weeks to mitigate any potential spread of the virus.

If I need to be tested for Coronavirus, can that be done at Promina Health?
Yes.  We now have a VERY limited number of specimen collection kits in the office and have received the personal protective equipment that we need to protect ourselves and other patients from being infected and infecting others. Many of you have heard that the test will be free to those who need it. This is included in the multibillion-dollar emergency aid package that was just signed by the President. We expect that it will take time for Quest Labs to get the details worked out. We don't have any details for how this will work with Quest, but that should not stop us from testing anyone that needs it.

What are the criteria for testing again?
The criteria for testing are still fairly narrow and include those with symptoms of: 1) Fever OR lower respiratory symptoms (cough, shortness of breath) AND known contact with a confirmed COVID-19 case; or 2) Have fever AND lower respiratory symptoms (cough, shortness of breath) and a negative rapid flu test.  Read the second one closely, if there is no known contact, both fever AND symptoms are required. It would be preferable to test everyone with cold symptoms but the testing capacity is just not there at this point.

What is the importance of testing? I don’t meet the criteria above, but I’ve been sick and I’m worried I have the coronavirus. Can I get tested?
The importance of testing is for the public’s health, not for the individual with the virus. There is no treatment for COVID-19, so even if an individual tests positive, the protocol is to self-quarantine for 14 days and treat each symptom (as you would with colds, flu, other viruses, etc.), stay in close touch with their physician, and alert their physician if symptoms worsen. Like for any respiratory illness, if the symptoms are severe enough, then hospitalization will be necessary. We are still working with many patients with cold and flu, which present with symptoms similar to coronavirus. As Spring arrives, we are also finding seasonal allergies flaring up. On top of that, we’ve had a number of patients contact us with gastroenteritis with vomiting and/or diarrhea. All that's to say that there’s still a lot of crud going around, so it’s best to treat all illnesses the same by refraining from contact with others (including going to work), frequent hand washing, resting, and watching for red flag signs of respiratory distress (being unable to breath well enough, working too hard to breath, breathing too fast). There is still limited access to COVID-19 test kits at this time, so we are obligated to use those in cases where the suspicion is high.  That may change in the coming weeks, but for now, there is no reason to be tested if you don’t meet the criteria.  

I have an appointment scheduled, should I come in?
Maintaining good health—coronavirus aside—should continue to be a priority for you. We have great telemedicine visit options through Spruce—including video capabilities.  If you have a visit scheduled but would prefer a virtual visit via Spruce or telephone, just let us know.  If you are well and you prefer to come in, we’re fine with that too, at least for the time being.   If you have prescription medications to pick up, we are happy to offer curbside service. Just give us a call when you arrive, and we’ll come out and bring them to you.

If I am congested or don’t feel well, should I come in or schedule a visit?
If you are sick and think you need to be evaluated, we want to assess your symptoms by phone or through Spruce first. We are continuing to reserve in-office sick visits for those with particular characteristics to avoid potential spread.  Anyone with cold or flu symptoms will be seen only in a designated time in which no other patients are in the office and will allow for extensive disinfection even beyond our already increased measures.  Anyone with suspected COVID-19 will be evaluated and tested in their car.

Are all of these drastic distancing practices and closures necessary?
Yes. The aim is to keep healthy folks from spreading it to more vulnerable individuals which could potentially result in a detrimental overload to our hospitals….where physicians are having to make decisions about who gets the limited number of ventilators…the elderly woman with coronavirus or the 25 year old who was in a near fatal car accident, or the 43 old woman who had emergency appendectomy surgery with life-threatening complications.

As always, we am grateful for the privilege to care for you and your family.